Abstract
Background Antiphospholipid antibodies (APAs) are found quite frequently in patients with non-Hodgkin’s
lymphoma (NHL). However, the clinical significance of these antibodies is largely
unknown. This study aims to delineate the clinical and prognostic role of APAs in
NHL patients.
Patients and Methods Consecutive patients of NHL were screened for lupus anticoagulant (LA), IgG/IgM
anticardiolipin antibody, and IgG/IgM anti-β2-glycoprotein I at the time of diagnosis.
Baseline investigations, staging, and treatment were done as per institutional protocol.
Patients were followed up until the last known outpatient visit or death. All were
screened at each visit for any thromboembolic event. The association of APA status
with baseline NHL characteristics and treatment response was evaluated by univariate
analysis. Kaplan–Meier survival analysis was used to compare the final outcome in
patients with or without APAs. Patients who were initially APA positive were retested
for the corresponding antibody at the end of chemotherapy.
Results Twenty-four out of 105 patients (22.8%) were APA positive at diagnosis. The presence
of APA was not significantly associated with NHL stage, histology, International Prognostic
Index score, activated partial thromboplastin time, or treatment response. The median
duration of follow-up was 15 months. Only four patients developed venous thrombosis;
none was APA positive. There was no statistically significant difference in overall
survival between the two groups (p = 0.471). Patients, who were APA positive initially, tested negative at the end of
treatment, irrespective of treatment response.
Conclusion APAs are encountered more frequently in NHL patients than in the general population.
However, APAs do not correlate with disease severity, thrombosis risk, treatment outcome,
or overall survival.
Zusammenfassung
Antiphospholipid-Antikörper (APAs) treten häufig bei Non-Hodgkin-Lymphom-Patienten
(NHL) auf, ihre genaue Rolle ist jedoch unklar. Wir verfolgten prospektiv 105 NHL-Patienten
über eine mittlere Dauer von 15 Monaten. Antiphospholipid-Antikörper wurden bei 22,8%
der NHL-Patienten nachgewiesen, eine Prävalenzrate, die viel höher ist als die der
Allgemeinbevölkerung. Neunzehn (79%) waren positiv für einen einzelnen Antikörper,
während fünf (21%) positiv für zwei Antikörper waren. Anti-β2-Glykoprotein I war das
am häufigsten nachgewiesene APA, gefolgt von Lupus-Antikoagulans und Anti-Cardiolipin-Antikörper.
Die mittlere aktivierte partielle Thromboplastinzeit unterschied sich nicht zwischen
den APA-positiven und den APA-negativen Gruppen. Nur 4 Patienten (3,8%) hatten eine
Venenthrombose entwickelt; Keiner war positiv für APAs. Der Status des Antiphospholipid-Antikörpers
korrelierte nicht mit dem Krankheitsstadium, der Histologie, dem International Prognostic
Index oder dem Ansprechen auf die Behandlung. Die Kaplan-Meier-Überlebensanalyse zeigte
keinen statistisch signifikanten Überlebensunterschied zwischen APA-positiven und
APA-negativen Patienten. Es wurde festgestellt, dass nur der Leistungsstatus das Überleben
signifikant vorhersagt.
Keywords
non-Hodgkin's lymphoma - antiphospholipid antibodies - lupus anticoagulant - anticardiolipin
antibody - anti-β2-glycoprotein I
Schlüsselwörter
Non-Hodgkin-Lymphom - Antiphospholipid-Antikörper - Lupus-Antikoagulans - Anti-Cardiolipin-Antikörper
- Anti-β2-Glykoprotein I
